The Alaska Native Tribal Health Consortium's (ANTHC) Center for Climate and Health has done a tremendous amount
of work over the past four years to support Alaska Native communities in chronicling climate change impacts on
the landscape and on human health. Staff members from the center apply their "engineering, environmental health
and community health experience to perform assessments, develop community-appropriate strategies, and to describe
climate-health connections."

Much of the early work has focused on areas of Alaska with high climate vulnerability, including the Northwest Arctic.
Impacts of climate change in the Northwest Arctic region range from thinning sea and river ice, to permafrost melting
and coastal erosion. Though many research groups are working to identify and monitor the changing environmental
conditions around Alaska, ANTHC's approach is unique both in its data collection methods and its focus, namely
community-based adaptation strategies.

In order to create effective adaptation strategies, leaders must consider a whole host of climate-influenced health
concerns. For instance, "climate change can indirectly increase the risk of infectious disease by damaging and
disrupting water and sanitation infrastructure" (Brubaker et al., 2011b). Climate change can also threaten food s
ecurity for communities that rely on traditional, permafrost-encapsulated storage cellars. The loss of reliable
refrigeration can in turn increase incidence of food borne diseases and can attract large predatory mammals, such as
bears, to population centers.

ANTHC employs western science, traditional ecological knowledge, and a vast network of climate change impact
"observers" to develop comprehensive, community-scaled climate change health assessments (CCHA). These
assessments, which include adaptation recommendations for individual communities, tackle complex health issues that
span the fields of both climate science and epidemiology. Part of the impetus for creating CCHAs was a desire to
provide support to community leaders who are tasked with creating protective climate change adaptation strategies in
response to unpredictable and rapidly changing environmental conditions. CCHAs provide technical input and relevant
data for community leaders who face the daunting challenge of drafting adaptation plans.

Mike Brubaker, Director of the Center for Climate and Health at ANTHC, has worked for years with Alaska Native
communities that are being directly impacted by climate change. Through this experience, Brubaker has been able to
identify a practical, stepwise process for communities initiating a climate change adaptation campaign. The process
includes the following steps:

Raise awareness

Identify your network

Engage in climate dialogue

Be a local environmental observer

Describe your climate baseline

Identify climate vulnerabilities

Develop targeted adaptation strategies

Climate Change Health Assessment Reports
Project Implementation and Progress
The very first assessment report was developed for Point Hope, Alaska in early 2009. Since that initial CCHA, a
total of five Alaska Native communities have participated in the comprehensive assessment process. The communities,
which include Point Hope, Kivalina, Noatak, Kiana, and Selawik, reside in geographically and culturally unique villages
ranging in size from 360-700 residents. Each of the community-tailored reports focuses on, "local observations and
traditional seasonal time scales, on [synthesizing] climate and health causal chains, and on a broadly participatory
framework, which combines Indigenous and Western knowledge systems" (Brubaker et al., 2011a). More specifically,
the assessments each include, "descriptions of climate-health mechanisms, vulnerability by health category,
measures of health risks and benefits, principles for adaptation planning and specific public health recommendations."

Rather than highly generalized regional assessments, local leaders can turn to CCHAs to better understand the
temporally and spatially specific "climate-health vulnerabilities" (Brubaker et al., 2011a) identified for
their particular community. Negative health impacts associated with climate change range from compromised drinking water
and wastewater infrastructure, to changes in the prevalence of zoonotic diseases. ANTHC assessment authors consider
health holistically and detail not only the physical, but also the mental health effects of climate change on Alaska
Native community members.

This tremendous resource is produced through collaborations between ANTHC staff and tribal representatives and
professionals. Brubaker et al. (2011a) describe the four-step process used to create a Climate Change Health Assessment
report as follows:

(1) Scoping to describe local conditions and engage stakeholders

(2) Surveying to collect descriptive and quantitative data

(3) Analysis to evaluate the data

(4) Planning to communicate findings and explore appropriate actions with community members

As a follow up to the five completed profiles, the Center plans to conduct three community-based assessments in Bristol
Bay, four in Alaska's North Slope region, and three in Norton Sound. The estimated dates of completion vary by region,
but all assessments are scheduled to take place within the next three years.
Importantly, Mike Brubaker explains, the climate change health assessments constitute only the first in a two-phase
process. During the first phase, the goal is to partner with communities and collect climate-relevant data, and then
synthesize the results into a comprehensive report. Also during the first phase, ANTHC staff work with communities to
identify which resources are already available for adaptation planning and which additional resources or projects are
needed. The second phase, meanwhile, focuses on implementation of the projects that were recommended during phase 1.

Completed Tasks Include:

Publication of five CCHA reports

Plans in place to complete an additional 10 reports within the next 3 years

Staff members from the center are currently developing metrics to better evaluate the magnitude of climate
vulnerabilities within Alaska Native communities (i.e. water resources, food security)

Communities that have already completed the assessment phase are now moving into the project implementation
phase. These communities will receive direct support from the Center for improvements to water, food, sanitation,
and medical infrastructure.

The LEO Network is sponsored by
the ANTHC and currently includes over 100 individuals in 60 communities throughout
Alaska. LEOs are "tribal environmental professionals who apply traditional knowledge, western science and
technology to document unusual plants and wildlife, extreme weather, erosion, flooding, droughts, wildfire and other
events that can threaten food security, water security and community health." LEOs receive monthly training through
webinars and have support from ANTHC throughout the year. In addition, the Center has created internal quality control
(QC) protocol for incoming observations to ensure that the data reported through the website meets a certain degree
of analytical rigor.

Observations may include photos, videos, and written accounts. Once submitted via the online reporting system, LEO
observations are made publically available so that interested parties throughout the region can learn more about local
climate change observations.

The network has compiled a comprehensive database of observations since its inception in 2011. Typical entries include
observed environmental trends like thinning sea or river ice, permafrost melt, and coastal erosion, as well as discrete
events or observations (i.e. discovery of a non-native fish skeleton). Mike Brubaker explains that the goal is to have
LEO participants throughout the state of Alaska chronicling climate-induced changes in the natural environment. This
will help to provide critical monitoring data so that communities can track short and long-term shifts in the surrounding
environs. The data can ultimately inform adaptation strategies and obviate the need for climate change mitigation
throughout the global community.

To access the LEO database, please visit (www.anthc.org/chs/ces/climate/).
Maps with local observations spanning from winter 2011 through fall 2012 are available through the LEO website.

Completed Tasks Include:

There are now over 142 trained professionals (LEOs) enrolled in the LEO network

These registered LEOs are actively collecting and reporting data from 84 communities (83 Alaskan communities and
1 community in the Northwest Territories of Canada)

In addition to managing the LEO network database, the Center also hosts LEO-themed tracks during state-wide
environmental management conferences

Challenges and Lessons Learned
When asked about the most significant challenges that his team has encountered, Brubaker responded that one major
challenge has been acquiring resources for Alaska Native communities affected by climate change. He explained that climate
change impacts can be readily observed across the landscape in Alaska – local residents live with the effects of climate
change on a daily basis. Resources to fund adaptation and mitigation have been slow coming however, because the global
community's perception of climate change belies the urgency and immediacy of the resulting needs. In response to this
challenge, Brubaker explains that we must "mainstream climate change adaptation" and help to ensure that
climate-vulnerable communities are adequately protected.

With regard to lessons learned, the ANTHC staff point out that every Alaska Native community is unique and that each is
experiencing "a range of climate impacts that are having effects on health." These climate-health impacts
frequently relate to water resources, food supply, and sanitation infrastructure. Nonetheless, the issues vary from
one community to the next, and it is only by engaging with community leaders and local residents and professionals that
staff members can evaluate suitable avenues for adaptation.

ANTHC staff emphasize that many impacted communities are already employing creative adaptation techniques. Intervention
and support are needed nonetheless because as Brubaker explains, "the scale of the disruption that's happening is
beyond the resources and capacity of rural Alaskan communities to deal with."

Key Partners:

Community members (LEOs)

U.S. Department of Health & Human Services, Indian Health Service

U.S. Environmental Protection Agency, Region 10 (Pacific Northwest)

Centers for Disease Control and Prevention, Arctic Investigations Program

Photos and maps in this profile are courtesy of the Alaska Native Tribal Health Consortium.

This profile was developed by Cristina González-Maddux, Institute for Tribal Environmental Professionals, Northern
Arizona University, with support from the U.S. Environmental Protection Agency.

The profile is available on the Tribes & Climate Change website: www4.nau.edu/tribalclimatechange/.
The tribal climate change profiles featured on the website are intended to be a pathway to increasing knowledge a
mong tribal and non-tribal organizations interested in learning about climate change mitigation and adaptation efforts.
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